Instrumental activities of daily living: a stepping-stone towards Alzheimer's disease diagnosis in subjects with mild cognitive impairment?

This paper challenges the requirements of normal activities of daily living/instrumental activities of daily living (ADL/IADL) functioning in mild cognitive impairment and stresses the need for further research and assessment refinement. Although people who develop dementia seem to experience subtle changes in complex IADLs long before the disease onset, studies that compare cognitively mildly impaired subjects with demented and nondemented subjects present no clear consensus regarding differentiation according to IADL ability. The traditional ADL/IADL assessment instruments and techniques seem to present a major problem when the purpose is to predict or differentiate between diagnoses. It is therefore argued that the diagnosis of MCI should include rather than exclude observed or experienced changes in complex everyday life activities.